Original article

Weight loss might be an early clinical feature of undiagnosed human immunodeficiency virus infection in Taiwan

¹ College of Medicine, China Medical University, Taichung 404, Taiwan
² Department of Family Medicine, China Medical University Hospital, Taichung 404, Taiwan
³ Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
⁴ College of Medicine, Tzu Chi University, Hualien 970, Taiwan
⁵ Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung 427, Taiwan

^* Corresponding author. Department of Internal Medicine, Taichung Tzu Chi General Hospital, No. 66, Sec. 1, Fongsing Road, Tanzi District, Taichung 427, Taiwan. E-mail address: kuanfuliaog@gmail.com (K.-F. Liao).

Received: 26 March 2018
Accepted: 24 April 2018

Abstract

Background/Objective: Little research is available on the relationship between weight loss and human immunodeficiency virus (HIV) infection in Taiwan. We hope to evaluate whether weight loss could be an early clinical feature of undiagnosed HIV infection in Taiwan.

Methods: We conducted a retrospective population-based cohort study using the database of the Taiwan National Health Insurance (NHI) Program. There were 4748 male subjects aged 1-84 with newly diagnosed weight loss as the weight loss group from 1998-2012 and 18982 age-matched male subjects without weight loss as the non-weight loss group. The incidence of HIV infection at the end of 2013 was measured in both groups. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for HIV risk associated with weight loss.

Results: The overall incidence of HIV infection was 3.79-fold higher in the weight loss group than in the non-weight loss group (6.83 vs. 1.80 per 10000 person-years, 95% CI 3.41, 4.21). The incidence was the highest during the first 6 months of follow-up in the weight loss group (39.0 per 10000 person-years). After adjusting for confounding factors, the adjusted HR of HIV infection was 3.63 (95% CI 1.77, 7.44) for the weight loss group, compared with the non-weight loss group.

Conclusion: Weight loss might be an early clinical feature of undiagnosed HIV infection in Taiwan. Male patients with weight loss who have risk factors for HIV infection should be recommended to regularly be tested for HIV infection.